When you think about plastic surgery, what's the first thing that comes to mind? Perhaps those Park Avenue doyennes with waxy visages, the starlets with too-puffy lips, or, most sadly, a once-beautiful woman who is rendered not younger — but unrecognizable? Those devastating signs used to be the hallmarks of cosmetic enhancements. But nowadays, it's nip/tuck not so much. New advancements in technology mean the end of "mannequin face" and the advent of truly natural-looking beauty.
As more and more women — some starting as early as in their '20s — search for better, more realistic ways to fend off aging, the industry has responded with a host of new, high-tech treatments that provide a purer form of pretty. The reason these treatments are becoming popular with a younger crowd? "Awareness, accessibility, and price point," explains Dr. Neil Sadick, clinical professor of dermatology at Weill Cornell Medical College and president of the Cosmetic Surgery Foundation. "The younger generation understands that replacing lost volume slows down the genetics of aging. They are using these fillers and toxins to prevent and postpone aging, not reverse it — I call this age prophylaxis." Adds dermatologist Dr. Dennis Gross," It's about stopping the wrinkle before the crinkle."
If getting prodded with needles and injected with chemicals all sounds a bit too Incredible Hulk to you, there's always a laser. "Many women are turning to laser treatment to avoid the immovable face look," says dermatologist Dr. Anne Chapas. "Because laser energies stimulate the body to repair itself gradually, the results can be more subtle and natural looking."
So what do you need to know before you book one of these high-tech treatments? "Not all doctors have the training to do this," says David Colbert M.D., founder of Colbert MD Skincare and the New York Dermatology Group and author of
The High School Reunion Diet
. "To avoid looking like Joan Crawford's long-lost drag-queen sister, make an appointment with a qualified dermatologist and not your GP or 'visiting Brazilian hairdresser' offering it in a midtown hotel off the medical map, otherwise you risk [looking like a clown] for a six-month purgatory. I've seen some truly gnarly results when an unsuspecting client gets a makeover from her dentist or ob-gyn." Colbert recommends you find a doc that is accredited by the American Board of Dermatology or the American Society of Dermatologic Surgeons.
Sadick says it's important to start a dialogue with the injector so they are clear on exactly what kind of results you expect. He advises you to explain that you want a natural look and still want to have expression and movement. "Remember that less is always more," he says. "You can always return for more filler, however it's difficult to take it out after it's been injected." Colbert's final words of wisdom? "If everyone in the waiting room looks related, politely cancel your appointment."
From lasers that literally melt fat to a sci-fi filler that makes you look younger by injecting your own plasma into your face, in the pages that follow we've pinpointed the 11 most notable treatments that are changing the way we look at plastic surgery today. Click through to check out these futuristic skin saviors for yourself.
What It Is: A hyaluronic-acid filler used for fine lines and to plump lips. Similar to Restalyne or Juvederm, but with more natural results and usually longer lasting. Since it has such a smooth injection, it's particularly beneficial for thin-skinned areas like the lips and eyes as there is less risk of rippling.
Who It's For: Anyone looking to plump up fine lines or areas of the face that have hollowed out due to loss of fat cells.
What To Expect: Expect to feel a pinching sensation at the site of injection, although many derms offer topical anaesthetic cream to help dull any pain. A full treatment usually takes about 20 minutes, depending on how many areas of the face you are treating. Effects can last for up to nine months, but doctors recommend coming in for a follow-up every six to 12 months to maintain the results.
What It Is: Also known as Platelet Rich Plasma (PRP) or the Vampire Facelift, this creepy-sounding treatment involves removing a tube or two of your blood, spinning it in a centrifuge to separate out the growth factors, then re-injecting the serum back into the face for a dewy glow and more resilient skin.
Dr. Colbert says this treatment can be done on any part of the body, from the face, to the hands, to the neck. If you're feeling really fancy, you can also combine your PRP with laser for an even dewier visage. "I have developed a new procedure called LaserPRP in which we prep the skin with laser toning, then inject the PRP immediately afterwards," says Dr. Colbert. "The laser stimulates the collagen-producing fibroblast cells, which then are more receptive to the PRP injections. It's like a Trojan Horse, delivering growth factors deep into the skin." Colbert says he regularly does this treatment on VS models Candice Swanepoel, Adriana Lima, and Erin Heatherton, who all gush about it. Works for us.
Who It's For: Those looking to rejuvenate and brighten their skin. Also, anyone who dislikes the ideas of neurotoxins, silicone, or other harmful chemicals being injected directly into their bodies.
What To Expect: Most physicians recommend a course of treatment of one to three injections spaced out over a four to six week period. Side effects include a temporary discomfort at the injection site, plus some redness, itching, and bruising.
What It Is: Using high-intensity focused ultrasound, this treatment literally melts away stubborn fat (our wish = granted), by focusing the ultrasound energy beneath the surface, causing a rapid heating of the fat cells. These melted cells are then absorbed into the body and expelled after a few weeks time.
Who It's For: This treatment is best used on those who have what Dr. Chapas calls a full dress size to lose. Best for those who are overall quite healthy, but who have stubborn pockets of fat, this treatment will help remove those bulges to create a sleeker, more streamlined physique.
What To Expect: The treatment wand is applied to your body to areas like the thighs, buttocks, or abdomen. There will be some mild pain, but Dr. Chapas says this can be managed with proper positioning and medication, where needed. If your pain tolerance is very low, your doctor may start you off on a lower setting. The enticing tagline for this treatment is that you can lose one inch, in one hour, with one treatment, which Dr. Chapas says has been consistent with the results she's seen with her patients. She also says that this type of treatment is the wave of the future: According to the Millenium Research Group, the non-invasive fat reduction market will grow by 42 percent annually through 2016 – nine times faster than its surgical counterparts.
What It Is: This hyaluronic filler is not yet out on the U.S. market. It features a larger molecule size, making it a close, yet more advanced cousin to Sculptra and Radiesse.
Who It's For: Best for those experiencing sunken skin and overall facial fat loss like hollowed cheekbones or a receding chin, be they caused by age or weight loss.
What To Expect: This deep tissue facial filler is injected into the supporting cushions of your skin. You will feel a pinching sensation at the injection site and some redness, swelling, or bruising is possible. The results are immediate and can last as long as 18 months.
What It Is: This treatment, done with the Syneron laser, is a 3-in-1 facial. It stimulates collagen to add firmness to the brows, cheeks, and jawline. It also lightens and rejuvenates the skin via exfoliation. According to Dr. Gross, it also helps minimize discoloration caused by rosacea, photodamage, and broken blood vessels. "It's similar to the Fraxel or Thermage, but with newer technology. It allows for less pain and penetrates deeper into the dermis," he says.
Who It's For: Dr.Gross says that while any age can benefit from Triniti, it's generally best for those in their 30s and 40s.
What To Expect: The treatment starts with an IPL session to target discoloration. This is followed by a firming laser and then a fractional laser to treat wrinkles. Patients can expect their skin to look red and feel sensitive for around 24 hours after having the treatment done. While you should see results right away, Gross says for optimal benefits you should do a series of treatments every three to four weeks.
What It Is: Billed as a competitor to Botox, this neurotoxin is currently only used for treatment of cervical dystonia. It briefly hit the injectables market last year, but was removed and banned from being used for facial aesthetic purposes after a lawsuit filed by Allergan, the makers of Botox, found that Merz, the makers of Xeomin violated the California Trade Secrets Act. Oh, pharmaceutical companies. Can't we all just get along?
Who It's For: When it finally does resurface, this treatment will be a good option for those wishing to reduce fine lines, crow's feet, frown lines, and smoker's lines. According to Dr. Colbert, it will also help rid the neck of ropiness and can create a lifted effect on the eye and brow.
What To Expect: Since it shares the same active ingredient as Botox — botulinium toxin A, Xeomin will presumably work the same way, relaxing the muscles at the site of injection to smooth out lines. It will also, purportedly, have the same side effects as Botox, including some redness, bleeding, bruising, and swelling at the injection site. According to Dr. Colbert, it will also take about a week or two for results to fully take effect.
Photo: Robert Daly
What It Is: Yet another Botox competitor, this neurotoxin is still awaiting FDA approval. One benefit of these new neurotoxins now flooding the market may be that it forces Allergan to lower the prices of Botox injections, since they now have competitors to deal with.
Who It's For: Anyone looking to smooth out fine lines and wrinkles.
What To Expect: SInce it hasn't been fully tested in clinical trials, it's hard to say what the actual effects of PurTox will be. However, early clinical trials have shown it has a quicker onset of action and possible longer-lasting effects, however this won't be confirmed until it is fully tested and used clinically.
Clear + Brilliant
What It Is: A fractional diode laser that targets tone and texture for improved overall appearance. Think of it as Fraxel with training wheels — less invasive, yet still very effective skin resurfacing.
Who It's For: While appropriate for all ages, Dr.Chapas has seen this treatment enjoy immense popularity with those men and women in their 20s and 30s who are looking to prevent the signs of aging. Perfect for those who have graduated from IPL, but aren't quite ready for Fraxel, this preventative treatment is preferred among those who are interested in retaining their skin's youthful appearance. It can also be used in conjunction with Botox and Thermage, or as maintenance for those patients between Fraxel treatments.
What To Expect: A numbing cream is applied to the skin prior to treatment. Once the treatment head is applied, you'll feel a slight tingling, and possibly stinging sensation. Afterwards, skin will be red for about 24-48 hours. Dr. Chapas recommends patients avoid harsh scrubs and sunlight exposure. Expect to undergo a series of two to six treatments at two to four week intervals.
What It Is: Fibroblasts, the skin cells in the dermis that produce collagen, begin to reduce in numbers as we age, causing less collagen to be created. This results in skin that is less resilient, more lax, and prone to wrinkling. Laviv is an injection of a fibroblast collagen matrix, derived from your own skin cells, that plumps up the dermis, filling in wrinkles.
Who It's For: Best for those who suffer from deep wrinkles, acne scarring, and prominent facial folding, specifically the nasolabial folds (read: smile lines).
What To Expect: Your doctor will take a small specimen of skin from behind your ears (where the scar won't show) and use that to create the fibroblast collagen matrix that will then be injected into your skin. It's crucial that only your matrix be injected, as using someone else's cells (Ed's note: um ew, creepy) can cause a serious reaction. So don't go sharing your Laviv with your BFF and be sure to confirm with your physician that those are indeed your skin cells they are injecting into your face. Results will last for up to six months.
What It Is: This non-invasive procedure relies on cryolipolysis, the use of cooling, to break down fat. By applying precisely controlled cooling to areas with excess fatty tissues, it can "freeze" and reduce excess fat in the back and abdomen.
Who It's For: Patients looking to get rid of fat bulges in their midsections. Dr. Chapas stresses that this is not a way to lose weight or treat obesity, and that it is not a substitute for invasive methods like liposuction. The treatment is aimed at relatively healthy, in-shape patients who are looking to gradually sculpt down small areas of resistant fat bulges on their bodies.
What To Expect: During the hour-long treatment, you'll be hooked up to a device that attaches around your midsection and gently and painlessly freezes away excess fat. You'll feel a firm pull and some pressure, but no pain. There may be some bruising, redness, or swelling afterwards. You can start to see results at up to three weeks afterwards, but the body will continue to flush out those frozen fat cells for up to six months after your treatment. While you will see a noticeable reduction in fat after one treatment, you may need multiple treatments to get your ideal shape.
What It Is: This "dermal remodeling" procedure delivers a controlled radio frequency directly to the deep dermis using microneedles injected in the skin. This stimulates skin's natural production of collagen, hyaluronic acid, and elastin, resulting in more supple, plump, and taut skin.
Who It's For: It works on all skin types, but is particularly beneficial for those searching to increase volume without injecting fillers into their face, and for those looking for both lifting and plumping effects.
What To Expect: The procedure takes about an hour and you will be put under local anaesthesia. You can expect some redness, swelling, and bruising for a few days. Because it delivers energy not through the surface of the skin, but directly into the dermis via needle, patients can expect to see increases in volume, elasticity, and lift. You'll see results after just one treatment, but you will continue to see improvement for another 30-60 days.